Objective To observe the efficacy of intra-articular (IA) blockade of TNF-α by 3 etanercept injections in patients with rheumatoid arthritis (RA).Methods Eighteen moderate activity RA patients with resistant knee synovitis underwent three monthly IA injection of etanercept (25mg).The primary outcomes were visual analogue scale of target knee general health (VAS-TKGH) and VAS target knee Pain Score,and we also collected diameter of target knee joint,VAS fatigue Score,Health Assessment Questionnaire (HAQ),the 28-joint based disease activity score (DAS28) and joint fluid volume,which were all assessed at baseline and every four weeks after IA injection.Results All those 18 patients completed the treatment with the average disease duration of was (8 4.7 ± 54.1) months.After each IA injection,VAS-TKGH was significantly improved than baseline (P =0.03,0.02,0.02).and VAS target knee pain score was also significantly improved than baseline (P =0.03,0.00,0.00).After 3rd IA injection,VAS-TKGH was further reduced compared with those after 1 st and 2nd IA injection (P =0.02,0.03) ; while,VAS target knee pain score was further reduced after 3rd IA injection (P =0.00).Knee joint diameter,VAS fatigue score,HAQ and DAS 28 were significantly lower after 1st IA injection than baseline (P =0.03,0.02,0.03).After 2nd IA injection,VAS fatigue score,HAQ,and DAS28 were significantly further improved compared to treatment once (P =0.00,0.02,0.02) ;after 3rd IA injection,HAQ and DAS28 were further improved compared to those after 2nd IA injection (P =0.01,0.02).Joint fluid volume was significantly decreased after 2nd IA injection (P =0.01).Conclusion The tailor approach of intra-articular injections of anti-TNF agent might benefit RA patients who had resistant synovitis,and the side effect was rare.However,the sample was small and further observation is needed.

Humans ; Integrative Medicine ; Medicine ; Medicine, Chinese Traditional

China ; Foundations ; Integrative Medicine ; Natural Science Disciplines

Tis study discusses the applicable relationship between Buyang-huanwu decoction and hemodynamic cerebral infarction from pathogenesis of Qi asthenia causing blood stasis.pathological features of hemodynamic cerebral infarction and the function and mechanism of Buyang-huanwu decoction and so on.It also investigates the methods of applying Buyang-huanwu decoction to treat hemodynamic cerebral infarction from such aspects as dose,occasion,contraindication and attentions.

The importance and necessity of undergraduates participating in the training plan of the medical research was clarified.Based on the actual ability of students and the characteristic of experimental teaching plan,we think that combination of experimental teaching of small group with research training is a strategy for enhancing the ability of the medical undergraduates to do research.This proposal will speed up the medical educational goal by the activation of novel idea,the cultivation of innovatory thought and the enhancement of creative ability.

The article reviewed the progress of traditional Chinese medicine in treating fibromyalgia syndrome and summarized the status and feature of different therapies in recent years in order to provide idea for the further researches. In addition, the article also discussed the problems and solutions of the researches.

Objective To compare the effects of desflurane and sevoflurane on somatosensory evoked potentials (SEP) in patients undergoing spine neurosurgery. Methods Thirty patients with ASA grades I-Ⅱand undergoing spinal deformity orthopaedic surgery were selected and divided into two groups: desflurane group and sevoflurane group (n=30) . Bispectral index (BIS),the state of muscle relaxation, SEP and hemodynamics were monitored during operation. By maintaining the BIS in the range of 35-45,the state of muscle relaxation disappeared and hemodynamic became stable. Adjust the concentration of anesthetic step by step from 0 to 0.3, 0.6 and 0.9 maximum alveolar concentrations (MAC), then inhaled different concentrations of drugs. Record the incubation period and amplitude of SEP before inhaling anesthetics (based on the value), in the moment of achieving each inhaled concentration ( T1, T2 and T3) , and the moment that the inhaled anesthetics blows completely (regression value) . The percentages of T1, T2, T3, and the regression value compared with basic value were calculated.Results Compared with the basic value, T1, T2 and T3 of left arm, left leg and right leg in desflurane group, T2 and T3 of right arm in desflurane group, T2 and T3 of left arm, left leg and right arm in sevoflurane group,and T2 and T3 of right leg in sevoflurane group showed incubation period delaying ( <0.05) . And the incubation period extended along with the increase of inhaled anesthetics dosage. Compared with the basic value,T1,T2 and T1 of left arm and left leg in desflurane group,T1 of right arm in desflurane group, T1 and T2 of right leg in desflurane, T3 of left arm in sevoflurane group, T1 and T3 in left leg in sevoflurane group had decreased amplitude ( < 0.05), especially T1. Compared with desflurane, sevoflurane showed a weaker inhibition effect on the incubation period and amplitude of T1,T2,T3 of left arm and left leg,T2 and T3 of right arm and right leg, and the amplitude of T1 of right leg ( < 0.05) . Conclusion Both of desflurane and sevoflurane have inhibition effect on SEP. The inhibition effect gradually strengthens along with the increasing of dose. The inhibition effect of desflurane is stronger than sevoflurane.

Currently, multimedia teaching plays a more and more important role in colleges.However, the negative effects of multimedia teaching have gradually revealed because of the neglection of its limitations. In this article, strategies were proposed from three different aspects against disadvantages of multimedia teaching in colleges in order to improve its role more effectively.

Objective To Evaluate the efficacy and safety of Qingre-Huoxue Recipe ( QHR ),Qingre -Huoxue Recipe and Methotrexate(QHR+MTX) in improving clinical symptoms of dampness-heat and blood-stasis syndrome of rheumatoid arthritis.Methods According to multi-center,randomized,and control intervention design,142 RA patients were randomly divided into QHR group (71 cases) and QHR+MTX group (71 cases).With clinical symptoms as evaluation indexes,FAS set and PP set were adapted for analysis.Results FAS set analysis:Both groups can significantly reduce pain VAS score [ (4.82 ± 1.98) vs (4.31 ± 1.85) ],reduce tenderness and swollen joint number[(4.87±4.05)vs(4.20±3.36)、(8.72±6.24)vs(7.14±5.03)respectively],shorten morning stiffness [ (39.56 ± 46.68) min vs (36.65 + 42.58) min] and significantly reduce the symptoms of fatigue[ (4.13 ±2.34) vs (3.74 ±2.20) ],also with good security.But there was no statistically significant difference between the two groups.Conclusion Qingre-Huoxue Recipe with MTX had no significant advantage in improving clinical symptoms in patients with the dampness-heat and blood-stasis syndrom of RA than without MTX.

OBJECTIVE:To observe clinical efficacy and safety of levofloxacin and azithromycin in the treatment of community acquired mycoplasma pneumonia (CAMP).METHODS:A total of 108 patients with CAMP were randomly divided into group A and group B (n=54).Group A received intravenous administration of levofloxacin (0.6 g,qd) and group B intravenous administration of azithromycinin (0.5 g,qd) for 7 days.The clinical efficacy and ADR of 2 groups were observed.RESULTS:The total effective rates of group A and group B were 83% and 56%,there was significant difference between 2 groups (P0.05).CONCLUSION:The clinical efficacy of levofloxacin in the treatment for CAMP is better than that of azithromycin.Levofloxacin and azithromycin have good safety.